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Hep C Discussion Forum -> On Treatment -> Genotype 2 Treatments
Post Info TOPIC: Genotype 2 Treatments
Linuxter


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Genotype 2 Treatments
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Thank You for these links, this is great information and very helpful ... thanks!

I hope you don't mind that I updated the original quote to reflect the current "Treatment of HCV Genotype 2" document.

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"Genotype 2: Initial Treatment

Background: Historically, treatment of genotype 2 infection achieved higher sustained virologic response (SVR) rates than with genotype 1 infection, even with a shorter duration of therapy and lower doses of ribavirin. Prior to the availability of direct-acting antiviral agents, the standard of care for treatment-naive patients with genotype 2 hepatitis C consisted of a 24-week course of peginterferon plus fixed-dose ribavirin, with SVR rates of 75 to 85%.

In 2013, the FDA approved a 12-week course with the all-oral regimen of sofosbuvir plus ribavirin for the treatment of genotype 2 infection based on data from several studies showing SVR rates of approximately 95% with this regimen.

Although daclatasvir is not FDA-approved for the treatment of patients with genotype 2 HCV, several studies have shown SVR rates greater than 90% with daclatasvir plus sofosbuvir, thereby providing a potential ribavirin-free option for patients unable to tolerate ribavirin.

There are a few caveats about this combination (Referring to daclatasvir plus sofosbuvir) for treatment of patients with genotype 2 infection: (1) daclatasvir has reduced activity against the relatively common genotype 2a M31 polymorphism and the clinical implications of this remain unclear, (2) the total number of patientswithgenotype 2 in whom this combination has been studied is small so the estimate of efficacy may not be precise, and (3) it is unclear whether genotype 2, treatment-naive patients with cirrhosis will need to extend treatment from 12 to 24 weeks with daclatasvir and sofosbuvir."

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http://www.hepatitisc.uw.edu/go/treatment-infection/treatment-genotype-2/core-concept/all
 
http://www.hepmag.com/articles/2512_18756.shtml
 
http://www.nejm.org/doi/full/10.1056/NEJMoa1306218


-- Edited by Linuxter on Wednesday 13th of January 2016 06:32:01 AM

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63yy,HCV,2b,F3-A1, Sof/Riba,12wks Tx   SOT: 1/20/16, HCV-RNA 9,816,581, ALT 56, Hb 14.6

4wk: HCV-RNA <15 Detected, ALT 15, AST 17, Hb 13.6 EOT: 4/12/16, ALT 18 , Hb 12.9176a2f85d05d9c965eafe199f2ba9ba5.jpg SVR Achieved 7/8/16

 
mallani


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Hi Miracle,

Sovaldi is the old sofosbuvir, not simeprevir. Simeprevir has not been used in Trials for Geno 2, and probably has disappeared from the Chemist shops by now.-

Harvoni, which has been approved for Geno 1 treatments,  is Sovaldi and Ledipasvir.

Unfortunately, Ledipasvir only blocks the Geno 1 NS-5A site, and has little action at the Geno 2 and 3 sites.
Daclatasvir may be useful, but Sovaldi/GS-5816 will be the top dog for Geno 2 and 3.

 

 

 



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Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
Miracleinprogress


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Oops...meant to say, one of the drugs in Harvoni is also the drug they use for genotype 2. Sovaldi (simeprevir) same...same. only difference is the added ledipasvir.

__________________

Genotype 2b. Not in treatment yet. F4-Cirrhosis (they say) Unknown years. Could be 51 or 35 years.
Miracleinprogress


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Thank you for starting a thread and the articles. I'm still not sure why Harvoni can't be used to treat genotype 2. Harvoni is two drugs in one and one of those drugs (sofosbuvir) is in Harvoni. I really am worried about the ribivarin mostly. I go in tomorrow to find out results with all labs and all treatment options. Have a page full of questions to ask. Will let you know :)

__________________

Genotype 2b. Not in treatment yet. F4-Cirrhosis (they say) Unknown years. Could be 51 or 35 years.
Tig


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Hi Rick and Miracle,

I saw your post Rick regarding Geno 2 treatments and wanted to give that to you on a different thread. I don't want to change the topic on the Harvoni Train, so I will post it here. Here is some of the recent information on the subject. There is also an upcoming treatment from Gilead, still in trial that include Sovaldi and GS5816. It will cover all genotypes with high rates of success as well. There is also Daclatasvir and Sovaldi. More news to come on that. Be sure to check the second link too. It has some useful charts. As I discover extra information I'll add it to the list of links. Things are changing fast! 

Tig

 

"Genotype 2: Initial Treatment

Background: Historically, treatment of genotype 2 infection achieved higher sustained virologic response (SVR) rates than with genotype 1 infection, even with a shorter duration of therapy and lower doses of ribavirin. Until recently, the standard of care for treatment-naive patients with genotype 2 hepatitis C has consisted of a 24-week course of peginterferon plus fixed-dose ribavirin, with SVR rates of 75 to 85%. In 2013, the FDA approved a 12-week course with the all-oral regimen of sofosbuvir plus ribavirin for the treatment of genotype 2 infection based on data from several studies showing SVR rates of approximately 95% with this regimen. The approval of this regimen represented a landmark introduction of interferon-free therapy for chronic hepatitis C. No hepatitis C protease inhibitors have received FDA approval for the treatment of genotype 2 HCV, but simeprevir has shown in vitro activity against HCV genotype 2."
 
http://www.hepatitisc.uw.edu/go/treatment-infection/treatment-genotype-2/core-concept/all
 
http://www.hepmag.com/articles/2512_18756.shtml
 
http://www.nejm.org/doi/full/10.1056/NEJMoa1306218


__________________

Tig

67yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 9+ years!

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